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COPD, Emphysema and such with Apnea.
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retired_guy Offline

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Machine: ResMed S9 Autoset
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Post: #21
RE: COPD, Emphysema and such with Apnea.
(08-13-2014 11:34 AM)retired_guy Wrote:  
(08-13-2014 11:08 AM)surferdude2 Wrote:  I have a question that is bothering me especially since I bought this ResMed S9 Elite used, although from a dealer who assured me it was like new. Here's my concern, when I first lie down and turn it on, it starts up right away (I don't use the ramp) and since I'm running the EPR at the highest setting (3) it starts throbbing away and I get some idea of how that pressure feels. Then somewhere around 20 ~ 30 minutes later, the pressure seems to have abated a great deal since I don't feel it nearly as much. Is that by design or do I have a defective unit? I might expect that from an auto unit but this is the straight CPAP Elite EPR and definitely not an auto. Huh

ps. My motorcycle days were in '55 so no worries Ann.

Yep, I think I know what's going on. There will be a time perhaps when you want your EPR at 3. But this is not the time. Change it to 2 and see if things don't flow a little smoother.

Vaughn had something to say about inhale/exhale pressures that make sense here:

http://www.apneaboard.com/forums/Thread-...7#pid79467

What I think happens is your airway is trying to constrict at the end of your exhale just as the inhale gets started. That accounts for the air hammer feeling you're getting.

By lowering the EPR to 2, what we're trying for is to keep the pressure a little higher on exhale while still providing you some benefit of the EPR for your emphysema.

It makes sense to me anyway, and I'm a rocket scientist.
08-13-2014 11:56 AM
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surferdude2 Offline

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Machine: ResMed S9 AutoSet
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CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
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Other Comments: Late stage 2 emphysema

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Location: Mousetown, Southern Illinois

Post: #22
RE: COPD, Emphysema and such with Apnea.
(08-13-2014 11:34 AM)retired_guy Wrote:  Yep, I think I know what's going on. There will be a time perhaps when you want your EPR at 3. But this is not the time. Change it to 2 and see if things don't flow a little smoother.

I'm gonna do that just so I can lay the blame on you if it doesn't help. i don't see what that has to do with the reduction in the higher pressure at inhale but so what, I'm new here at this. I just was wondering if the unit had some sort of algorithm that reduced the pressure when my relaxed breathing pattern begins. I doubt that since it would seem that that would welcome flow restrictions aboard and create problems. I guess that wouldn't be a problem if it actually started at a higher rate than I select and then settled down to the proper rate in the time period or for the reason I stated. Does any of that sound like the way these things are supposed to work?

I just about talked myself out of trying the EPR setting of 2 rather than 3 but I'll dwell on that later. I actually don't like all that pumping action on my face while trying to forget that I need to concentrate on forgetting everything and get to sleep as fast as possible. Lots of pressure there in more than one way.

And another thing, what does Al Gore's Rythm have to do with anything?

Maybe I'll get a cheap manometer and and check this problem out scientiffik..scientistic..err...in a more better method. I see those for around 7 bucks on Amazon. They use them for Radon gas management system monitoring.

I'm done.Okay
08-13-2014 12:00 PM
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retired_guy Offline

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Posts: 2,744
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Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
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CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #23
RE: COPD, Emphysema and such with Apnea.
(08-13-2014 12:00 PM)surferdude2 Wrote:  I'm gonna do that just so I can lay the blame on you if it doesn't help.

Ok. I can handle that. You ought to see all the stuff Mrs. Retired_Guy blames on me.

So, blame away, I'm good with that. Just give it a try.
08-13-2014 12:11 PM
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bwexler Offline

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Post: #24
RE: COPD, Emphysema and such with Apnea.
You guys almost made me wish I had COPD (almost).
I haven't had such a good laugh in a while.
I do help my BIL with his APAP experience and he also has COPD.
After just over a year, last night he managed to string 2 nights in a row using the machine for 4 hours. Just told my wife it made him feel great.
I barely have 1,000 hours invested in trying to convince him to use the machine. Now if we can get some meaningful data and tweak his settings, his life could be as good as RG.
He has tried some interesting techniques with his Wisp nasal mask, like leaving one headgear strap not connected. He said it was more comfortable that way. Hardly affected his leaks at all, since he also slept with his mouth open. Now he even has a chin strap. He was confused about weather the extra strap went behind his head or over his eyes.
08-13-2014 02:58 PM
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surferdude2 Offline

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Machine: ResMed S9 AutoSet
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Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #25
RE: COPD, Emphysema and such with Apnea.
bwexler, Laughter is indeed the best medicine. Your Bro in law sounds to be more fun than a barrel of rum (or was that monkies). It takes a lot of time and a keen eye to spot anything funny about COPD but it's good diversion from desiderium (you need to look that word up). COPD is about as funny as a heart attack in slow motion.

Get your BIL in here and maybe we can ask him why he isn't more grateful to you for all that nagging you've been so generous with.

I'm sure we can all benefit from bouncing our experiences and concerns off one another as they pertain to the double whammy of COPD & OSA and manage to occasionally apply some of that best of all medicine, laughter.
oldman
08-13-2014 03:27 PM
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retired_guy Offline

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Posts: 2,744
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Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #26
RE: COPD, Emphysema and such with Apnea.
(08-13-2014 02:58 PM)bwexler Wrote:  After just over a year, last night he managed to string 2 nights in a row using the machine for 4 hours. Just told my wife it made him feel great.

That's good stuff bwex, Congrat your BIL for us. Now that he knows the therapy will make him feel better he's ripe for using it all the time.

Actually the whole COPD thing is overrated. They didn't even call it COPD when I was a pup. They had stuff like Asthma and all that that, but not COPD. So I think it's something someone just made up. So Surfie can just get over it now.

Don't know about the "laughter" stuff either. I don't do that. I have never laughed... Well, I did last week once. It disturbed the voices and they told me to knock it off. So I did. Except the one guy said laughter is good for the soul and healing and fun to do and really a cool thing. So the other voices beat him up.
08-13-2014 06:06 PM
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annbower1125 Offline

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Post: #27
RE: COPD, Emphysema and such with Apnea.
this is the most recent one, going to see a pulmo so hopefully I will find out whats up, I am only 50 and the lung age is 82 lol
08-14-2014 11:32 AM
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surferdude2 Offline

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Machine: ResMed S9 AutoSet
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Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #28
RE: COPD, Emphysema and such with Apnea.
@ annbower1125, You're not doing all that badly on the spirometry test and besides those things have a wide range of inaccuracy and it's always on the side of under reporting. The accuracy is largely dependent on the person doing the blowing and how well they do that. Sooo...you could still be within your age range if you apply a multiplier of 1.25 to the results, which allows for the full 80% error.

The pulmonologist will give you the best asessment and hopefully your fears can be put to rest. Then you can come back and avail yourself of the expertise of the good folks here who so generously give of their time and knowledge to help those like me who would likely hurt themselves trying to work things out alone. All the best wishes to you and please keep us posted.

@ retired_guy, My results from setting the EPR to #2 are encouraging although I clouded the water a little by also setting a slightly higher pressure for the session since it was in keeping with my search. I'll give you full credit so bask in the glory of the moment and refrain from openly gloating lest you injure yourself posturing. It looks like a too low of an EPR setting could be compared to allowing the door to slam shut and have to be reopened on every breathing cycle. Sometimes it doesn't get opened quickly enough and therein lies the apnea event. Does that sound reasonable? Huhsign
08-14-2014 02:06 PM
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retired_guy Offline

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Posts: 2,744
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Machine: ResMed S9 Autoset
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Mask Make & Model: Resmed Airfit P10
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CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #29
RE: COPD, Emphysema and such with Apnea.
(08-14-2014 02:06 PM)surferdude2 Wrote:  @ retired_guy, My results from setting the EPR to #2 are encouraging although I clouded the water a little by also setting a slightly higher pressure for the session since it was in keeping with my search. I'll give you full credit so bask in the glory of the moment and refrain from openly gloating lest you injure yourself posturing. It looks like a too low of an EPR setting could be compared to allowing the door to slam shut and have to be reopened on every breathing cycle. Sometimes it doesn't get opened quickly enough and therein lies the apnea event. Does that sound reasonable? Huhsign

Excuse me? What was that you said? Oh yeah, I remember now: I'll give you full credit so bask in the glory of the moment

Yeah that was it.....

Nah, nah nah, na nah nah.......... I'm the man! I'm the man....

But, in all humility, I must say no, I don't deserve the credit. You do for following instructions!!!!

Nevertheless I'm glad this is helping. I had that experience myself somewhile back. The real credit belongs to Vaughn for explaining the situation so well here: http://www.apneaboard.com/forums/Thread-...7#pid79467
08-14-2014 02:42 PM
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surferdude2 Offline

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Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #30
RE: COPD, Emphysema and such with Apnea.
I'm afraid I must insist, I give you full credit. If things turn sour later, I'll have you to thank. You're cornered and trapped and you know it so quit trying to wiggle out of the clever trap I set for you. Dielaughing

Seriously, If lowering the EPR isn't my long term answer, assuming I may have to go higher on the inhale pressure and may not be able to tolerate the resultant expiratory resistance, even at setting #3, then I suppose I'll need to ask what kind of box would I need then. Perhaps a VPAP?
(This post was last modified: 08-14-2014 03:01 PM by surferdude2.)
08-14-2014 03:00 PM
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